KFWE Employer Benefits Information & Needs Intake

KFWE Employer Benefits Information & Needs Intake

Share your employer details and benefits needs—answer only the questions that apply to you, then confirm your contact permission.
Contact/Business
Contact Name

First NameLast Name
Job Title / Role
Business or Organization Name
Work Email
example@example.com
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Contact Method
Your Role in the Organization

Other
Number of Employees using ranges
How many employees do you have?
Which applies to your business?

Other
Current Benefits
Which benefits do you currently offer?
For the benefits you offer, how are they generally funded?
Which benefit plans are employer-sponsored?
Which benefit options are employee-paid?
Anything else we should know about your current benefits setup?
Renewal/Review Timing
When are your benefits due for renewal, review, or open enrollment?
How soon would you like us to follow up?
If timing is urgent, please share any details we should know
Benefits They Want to Explore
Which benefit areas would you like to explore for your team?

Other Employer Benefit Solutions
What are you hoping to improve or learn about these benefit areas?
For medical coverage, what would you like to explore?

Other
For dental and vision, what would you like to explore?

Other
For financial protection and voluntary benefits, what would you like to explore?

Other
For employee support and wellness, what would you like to explore?

Other
Employee Priorities
What are the top priorities for your benefits program?

Other
Which matters most right now?

Other
Which employee experience areas would you like to improve?

Other
How important is a competitive benefits package for attracting and keeping employees?

1

2

3

4

5

6

7

8

9

10

1 is Not important, 10 is Extremely important
Employer Budget/Contribution approach at broad level
Employer contribution approach
Preferred budget range
Contribution flexibility

Need guidance on best approach
Additional budget or contribution notes
Contact Permission & Acknowledgment
Permission to contact by phone

Yes, you may call me
Permission to contact by email

Yes, you may email me
Permission to contact by text message

Yes, you may text me
Should be Empty:

KFWE Employer Benefits Information & Needs Intake

Contact/Business

Number of Employees using ranges

Current Benefits

Renewal/Review Timing

Benefits They Want to Explore

Employee Priorities

Employer Budget/Contribution approach at broad level

Contact Permission & Acknowledgment